Lyme disease is the fastest-growing tick-borne disease in the United States, with over 476,000 people diagnosed each year. While people are usually familiar with common clinical signs of early Lyme disease like erythema migrans rash, flu-like symptoms, joint pain, and swollen lymph nodes, they may not realize that in severe cases, untreated Lyme disease can spread throughout the body. It can affect the central nervous system and various organs, sometimes causing chronic infection. One question that often arises is whether this bacterial infection can affect the liver. We will explore the relationship between Lyme disease and liver health.
Lyme disease (Lyme borreliosis) is an infection caused by the bacteria Borrelia burgdorferi, which is transmitted through the bite of an infected black-legged tick. Lyme disease is found throughout North America and other parts of the world, and cases have been reported across the United States. New England, the Upper Midwest, and the Pacific Coast are particular hotspots for this tick-borne illness. While other types of ticks such as the lone star tick carry different diseases like Rocky Mountain Spotted Fever, the Borrelia burgdorferi bacteria is only transmitted via a black-legged tick bite. Black-legged ticks are sometimes called deer ticks.
There are three stages of Lyme disease. In Stage 1 (early localized disease), some people get an erythema migrans rash that may or may not look like a bull’s eye. Other common early symptoms are fever, chills, fatigue, headache, stiff neck, muscle soreness and joint pain, swollen lymph nodes, and sore throat.
Lyme disease is treated with antibiotic therapy, but because Lyme is difficult to diagnose, not everyone gets appropriate or timely antibiotic treatment. In Stage 2 (early disseminated Lyme disease), the bacterium Borrelia burgdorferi begin to spread throughout the body, causing an increase of symptoms like chills, fever, headache, and fatigue, as well as new symptoms such as pain, weakness or numbness or the arms or legs; vision changes; Lyme carditis; new appearance of rash; and facial palsy.
In Stage 3 (late disseminated Lyme disease), the bacteria can spread to the nervous system and into the heart and joints. Symptoms of Stage 3 Lyme disease include arthritis in large joints or near the point of infection, severe headaches or migraines, vertigo or dizziness, migrating pains that come and go in joints and tendons, stiff neck, sleep disturbances and insomnia, disturbances in heart rhythm, brain fog, numbness in the extremities, and severe fatigue.
As the immune system works to fight Lyme disease, the liver can be impacted. The liver releases proteins as part of the immune response to infection, including inflammation. Research shows that patients with early Lyme disease often have at least one liver test abnormality, and sometimes more than one. The most common elevated liver function tests in Lyme disease patients are gamma-Glutamyl transpeptidase and alanine transaminase.
Patients with Stage 2 Lyme disease are more likely to have elevated liver function tests than those with Stage 1 Lyme disease. Elevated liver enzymes may mean that the liver is a site of infection during Lyme disease. In addition to elevated liver enzymes that might show up on a laboratory test, liver-specific symptoms of Lyme disease include abdominal pain and hepatitis-like symptoms.
Liver disease including liver damage or liver failure is a rare but severe complication of Lyme disease, affecting a small number of individuals. In most cases, liver enzymes go back to normal after Lyme disease is treated with antibiotics.
Lyme disease is a clinical diagnosis that a healthcare provider will make based on your symptoms and exposure to ticks. A clinical diagnosis can be corroborated by blood tests, but laboratory tests cannot be used alone to determine if a person has Lyme disease. People can get both false negative and false positive Lyme test results. Liver enzyme tests may help your doctor determine if you have Lyme disease, and they can be monitored during your infection. After antibiotic treatment for Lyme disease, your liver function should return to normal.
In addition to antibiotic treatment, other measures may be recommended to aid in liver recovery. These can include:
Consult your healthcare provider for accurate diagnosis and appropriate treatment.
Early detection and proper management of Lyme disease is the most important thing for your liver health. With appropriate care, the liver can recover from Lyme disease complications.
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